ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2168

Temporomandibular Joint Involvement and Quality Of Life In Juvenile Idiopathic Arthritis

Paula Frid1,2, Ellen Nordal3,4, Francesca Bovis5, Denise Marafon5, Donato De Angelis5, Sheila Oliveira5, Fabrizia Corona5, Gabrieli Simonini5, Joyce Davidson5, Helen Foster5, Rik Joos5, Ivan Foeldvari5, Michel Steenks5, Pekka Lahdenne5, Pavla Dolezalova5, Elena Palmisani5, Alberto Martini5, Angela Pistorio5 and Nicolino Ruperto5, 1Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, Tromso, Norway, 2Public Dental Service Competence Centre of Northen Norway, Tromso, Norway, 3Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, 4Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway, 5Istituto Giannina Gaslini, Pediatria II, Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO) Coordinating Center, Genoa, Italy, Genoa, Italy

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Pediatric Rheumatology-Clinical and Therapeutic Aspects III: Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Diseases

Session Type: Abstract Submissions (ACR)

Background/Purpose: Temporomandibular joint (TMJ) arthritis in childhood is seen in a substantial percentage of children with Juvenile idiopathic arthritis (JIA) and may lead to reduced mouth opening, pain and craniomandibular growth disturbances. The purpose of this study was to assess the prevalence of TMJ involvement in a JIA cohort and the association between TMJ involvement and other disease variables such as cervical spine and upper limb involvement, and the impact of TMJ involvement on daily life.

Methods: This descriptive study is based on data from a cross-sectional sample from 32 countries worldwide between 1998-2000, diagnosed with JIA, enrolled for validation of the Child Health Assessment Questionnaire (C-HAQ) and Child Health Questionnaire (CHQ), and also children enrolled in the PRINTO Methotrexate (MTX) trial. Disease activity and quality of life were assessed. Diagnosis of TMJ involvement was based on clinical assessment of the presence of swelling or limitation of motion (LOM) with pain and/or tenderness in at least one TMJ.

Results: Of the 3344 children included, 68.3% were female and 45.8% were diagnosed with persistent or extended oligoarthritis. The prevalence of TMJ involvement was 11.6%. TMJ involvement was strongly associated with polyarthritis (odds ratio (OR) 9.8 (confidence interval (CI) 6.1-15.8)), systemic (OR 7.4 (CI 4.5-12.3)) and extended oligoarthritis (OR 6.7 (CI 4.0 – 11.1)) > 2 joints with LOM in upper limb > 2 (OR 9.8 (CI 7.5 – 12.7)) and cervical involvement (OR 7.8 (CI 6.2-9.8)) in univariate analysis. Finally, a multivariate logistic regression model with the disease activity measures, polyarticular JIA course, active joints >5, MTX use, female gender, age at visit, higher CHAQ scores, erythrocyte sedimentation rate (ESR), positive rheumatoid factor (RF) and other variables was performed; we underline the role of the following predictors in the association with the TMJ involvement: cervical spine involvement (3.0 (CI 2.2-4.0)), eating difficulties (1.2 (CI 1.0-1.4)) and superior limb involvement (1.1 (CI 1.0-1.1)).

Conclusion: The prevalence of TMJ involvement was low in this large cohort compared with other studies probably due to a diagnosis based on clinical diagnostic criteria only. However, we found significant associations between TMJ involvement and cervical spine involvement, upper limb involvement, and eating difficulties. Further studies with both clinical and imaging diagnostic assessment of TMJ involvement in a longitudinal cohort study are warranted.

Disclosure:

P. Frid,
None;

E. Nordal,
None;

F. Bovis,
None;

D. Marafon,
None;

D. De Angelis,
None;

S. Oliveira,
None;

F. Corona,
None;

G. Simonini,
None;

J. Davidson,
None;

H. Foster,
None;

R. Joos,
None;

I. Foeldvari,
None;

M. Steenks,
None;

P. Lahdenne,
None;

P. Dolezalova,
None;

E. Palmisani,
None;

A. Martini,
None;

A. Pistorio,
None;

N. Ruperto,
None.

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